The industrial community has expressed keen interest in health promotion/disease prevention (HP/DP) programs as a way of improving cardiovascular health and reducing health-related costs among employees. However, there is insufficient information available about the effectiveness or efficiency of each of the various program models that are available. HP/DP programs can generally be differentiated into risk reduction and health promotion components. Risk reduction activities focus on the identification of specific risk factors and the development of interventions to reduce those risks. Health promotion activities, in contrast, focus on various types of life style changes aimed at positive wellness (not just the absence of illness or risk). In addition, some program designs include substantial amounts of on-site activity designed to involve maximum numbers of employees in the program, while others are primarily low-cost promotional devices to educate and inform employees. While occasional studies have demonstrated positive outcomes for specific program components, no studies are available that examine the relative effects of different program designs, or of risk reduction as compared with health promotion activities. In addition, little information is availaable about the cost-effectiveness or cost-benefit of these programs. The proposed study uses a quasi-experimental design involving four matched auto manufacturing plants, with one control site, one promotional or paper program site, one risk reduction site, and one health promotion site. Effects of each program model will be evaluated, including reduction of three targeted cardiovascular disease risk factors within the plant population--cigarette smoking, high blood pressure, and overweight, and changes in absenteeism, turnover, mortality, disability, and medical benefit utilization. Cost of implementing each model will be documented, and cost-effectiveness and cost-benefit analyses conducted.